Ask Stacy: How Can I Fight an Unfair Medical Bill?

This reader went to the doctor to have a single tick removed, and now it’s the $750 bill that’s under her skin. Is there any way she can get it reduced?


This week’s question is from a reader who’s ticked off at a doctor. Literally.

On April 29, I went to a walk-in clinic to have a tick removed from my head (I could not remove it because I could not see it) and on Friday, May 31, I received a bill for $750 to be paid by May 28. Is this normal, and is there anyone who can help me? Am I to blame for not asking the cost of this before they helped me? I am in my 60s, and this has been so stressful. — Sara

If this story had been about any business other than health care, I would have thought this reader was pulling my leg, because the price is so out of line with the service received. But because it concerns medical costs, I find it not only believable, but likely.

Exactly what are these services worth?

A couple of years ago I had a high fever and couldn’t immediately get in to see my doctor. I was in such misery, I drove myself to a nearby hospital emergency room. After a few hours, a few tests and a shot of antibiotics, I was on my way.

Several days later I got the bill: $2,400.

My first call was to the hospital, and my first question was if they’d sent their bill through my health insurance company. They said no, their records reflected I was uninsured. I explained that I was insured and provided my health insurance information.

A few weeks later, I got a new bill: $600.

Despite having insurance, I had to pay the $600, because my deductible was $6,000. But where else in America does a vendor charge one customer $600 and another $2,400 for the exact same service? Imagine how you’d feel if you paid $50,000 for a new car, then found out I’d bought the same car from the same dealer on the same day for $12,500.

The services the hospital supplied were presumably profitable at $600; otherwise they wouldn’t have agreed to that rate with my insurance company. Yet they had no problem charging an uninsured person 300 percent more. And if that person was unwilling or unable to pay this inflated bill? The account would go to collections, the collection agency would sue and get a judgment and that person’s credit would be ruined.

Time magazine reporter Steven Brill made the talk show circuit in 2013 after writing a comprehensive story about this exact issue: hyper-inflated medical bills ostensibly created out of thin air and in no way related to the cost of the services provided. While Brill did a great job on his story, the subject is nothing new. We covered it in 2009: See “Killer Hospital Bills.”

Sara asks, “Am I to blame for not asking the cost of this before they helped me?” Answer: We should all ask the price of anything before agreeing to it.

When it comes to health care, however, that’s often easier said than done. Sure, Sara could have asked the cost for tick removal and, after being beaten up this way, it’s likely she’ll do so in the future. But how could I get an advance quote on fixing my fever when the services needed to be performed before the cause was known? Even if I hadn’t been practically delirious, there was no way for me to comparison shop.

What should Sara do?

The first thing Sara should do is what every consumer should do when confronted with any bill that feels unfair. Contact the person responsible, calmly explain the situation and, in the friendliest possible way, ask to have the bill reduced. Whether it’s a plumber, a restaurant or a doctor, you have every right to question a bill and ask for an adjustment if the cost is unreasonable in relation to the services provided.

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Comments

  • whattarush

    I would imagine that many places that perform “emergency” services don’t know how much the billing office would charge. They seem to be two separate entities working for the same company. A right hand and a left hand that don’t know what each other is actually doing. So, while asking for an estimate before being treated makes sense, you may not get what you asked for. These days, going to an urgent care center might make more sense IF your own doctor can’t squeeze you in or it’s after office hours, rather than going to an emergency room at a hospital. The hospital seems to do so much more than is necessary to get a diagnosis. I don’t know if they are trying to cover all bases or if they are trying to inflate the bill. Besides, they probably don’t have your records on file to refer to. Luckily, if I ever needed services of an urgent nature, I could go to another office in the same building that is a part of the parent company. They have my records, because they are linked. I would say that before anyone needs services of an urgent nature, they need to make a plan about where to go for the most cost-effective services in advance.

  • me

    I worked in a hospital lab years ago. Every time a doctor wrote and order for a test, a change slip would be pulled from the order and immediately sent to billing. Unfortunately, it was common for the doctor to forget and re-order or another doctor order the same tests on another shift. If the receptionist did not notice multiples (as they could be sent on different shifts and there was a capacity for 1000 patients) then the patient would be billed for duplicate tests which did not happen. It is always good to make and appointment with the billing office and go over the bill with a fine tooth comb. It is likely there is a mistake somewhere!

  • Joseph Freitas

    Rarely do I get a price when I ask when it comes to medical care. Rarely is anything right really. From what I schedule/request, what I get, and what I get billed for. Hardly ever will they correct anything. Also, no matter what, the doctors and insurance companies will blame it all on you.
    You pretty much can’t do anything other than file complaints.
    I recently got a call from my doctor over an issue. He says “I’m sorry this happened to you, you didn’t have to report us to the better business bureau” Really? Did I have pay more money because you messed up and blamed it on me? Yep, so I did have to report you.

  • Marie Lee

    When you received a bill for $600 because you have insurance, the hospital or clinic did not drop the price. Instead, they got the difference from the insurance company. In some cases, the price is discounted due to the fact that they may have a contract, but basically you are just paying your portion depending on what the insurance company covers. This is why when people say they can’t “afford” health insurance, I always ask: “Can you afford the medical bill if you don’t have insurance?” True that they charge quite a bit, but these are professional people that are doing a job that you cannot do.

  • Georgia Wessling

    I guess I am okay because I am on Medicare/UMR. Medicare will only estimate how much a service is worth and then pay 80% of that. You or your insurance company pays the rest. I am still paying some as I have a $1,300 out-of-pocket and a $300 co-pay. Nine-tenths of the time I do not even see a bill until after it has been through Medicare and UMR. I see it when they send a bill telling me how much I owe. That is a little late for me to be complaining about the charges.

  • Lorilu

    If a hospital can see fit to charge a reduced rate for patients with insurance coverage, they ought to charge individuals without coverage the same amount, not the “rack rate.”

    This lady should speak to the billing office, and ask for a reduction in the price, or a payment plan.

    While handling bills for a deceased relative, they received a bill for a procedure performed nearly two years ago, for which they had never been billed before. The hospital even stated that the bill had been lost in their system. I learned, from a hospital biller, that we need only send the hospital a letter saying that the bill had not been submitted in a timely manner (six months or less), and therefore would not be honored. We did that, and were never billed again.

  • Georgia Wessling

    Oops! UMR and I only pay the 20% Medicare didn’t. We are not responsible for what Medicare set aside.

  • Mado_Ale

    Dear Sara,

    I hope you read this comment. I was hit by a car 10 years ago and I continue to receive medical treatments as a result to this day. I deal with unpaid medical bills on a daily basis because my auto insurance deny them even though they would be 100% related to the accident, and therefore I would have no choice but to pay them out of pocket and then have my attorney go after my auto insurance company for reimbursement. He is my advice to you (this has worked for me 99% of the time). The first thing I would do is “explain to the medical provider my financial situation and let them know that I only make a little of than $1,000 per month, and that it is hardly enough for my rent, utilities, food and public transportation per month.” The second thing I would do is I would ask this very, very important question, “Do you guys offer charity discount for uninsured patients.” 99.99% of medical providers do. If so, then ask them to send you a charity discount application in order for you to it fill out and send it back to them. After you send the application to them, just sit back and relax. The process usually takes the medical provider 30 days to respond. The charity discount is about 70% of the total amount. So in my case I owed a bill for an emergency room physician in the amount of $497 and all I had to pay was $149.10. In your case 25% of $750 would be $187.50. If the medical provider does not offer charity discount, then you ask the following question, “What is the lowest amount you would take?” In your mind, 50% or $375 as payment in full. I repeat “50% AS PAYMENT IN FULL. Do not make any payments (50%) unless you get a confirmation email, and this is how you can ask for a confirmation email. Say “I want you to email me or fax me that you will accept $375 as payment in full through (have them state the day and date you talked to them) with the instructions on how to make the check payable and where to send it.” If they refused to email you, then ask them to mail you a prorated statement that they gave you 50% in order to make a payment in the amount of $375 as payment in full. Be careful in case the rep said you can make monthly payments until the bill is paid in full, what they mean by that is you could make monthly payment on the total amount ($750), and this is a technique they use to get you to pay the total amount owed in full. In this case you need to say I cannot afford that, however, I am willing to get a loan in the amount of $375 (assuming he/she agreed to %50 as payment in full) and pay it off “as payment in full.” It take a little bit of persistence and patience, but it is doable.

    Lastly, be patient when you contact the medical provider, write the name of the rep, date and time down. Also, write down what was discussed if you reached an agreement with them. You will need this info in case you need to call back if it takes them more than 30 days to get back to you. I have encountered some customer service representatives who told me “I am sorry I can not make such a decision (offer you charity discount or accept 50% as payment in full), however, this is what you should do in this case. Ask them “Can I please talk to a person who can help or make a decision?”

    Please feel free to ask me any questions you may have. Hope that helps. Good luck.

  • Gretchen Saaduddin

    My Dad us in a horrible subacute hospital from which we want to remove him. We have constant issues with positioning for bed sores, issues with them not discontinuing a trach which was to be done months ago, problems with not turning on his feeding pump, or malfunctioning feeding pump. He was like. “jock” (a very athletic 93 year old) when he had a fall. We put him into a residential facility for what was to be a short time. Insread of toileting him, they made him wear diapers, but did not change him. Unbeknownst to us, they were not following their beautiful posted menu, but fed him Campbell’s soup instead. In spite of multiple request to rent a hospital bed, this was not done, and he did a “face plant” on their concrete floor. The ER uncovered a huge number of pressure ulcers and bed sores. The worst was on his coccyx. His prealbumen indicated starvation conditions as well as severe dehydration. This was the beginning of his downward spiral. Each home appeared beautiful, but was staffed by ignorant, uncaring, callous staff. There was constant pressure on us to just let him go. With the use of a bodybuilding concoction I used to take when in the sport, I was anle to get his wound healed enough to do the flap surgery. But true to form, while my family was struggling with bronchitis, they stopped feeding and hydrating him

  • mae’s mae

    My mother was injured in an accident last year, after have ONE ct scan of her neck she received a $10,000 bill. The billing statement lists only that one scan for that amount.The billing company has ignored over 100 attempts at contact via attorney to negotiate and have previously told my mother that will under no circumstances reduce the bill. What more can be done? As this is an extremely high amount of money. The average cost of this scan that I have been able to find is between $300 and $3000.

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